Green Star Mother Demands Answers from VA Secretary

Two or three days after my son Cody Camacho, an Army veteran, took his own life, I was sitting at his dining room table with a good friend of his who had been talking with him about opening a business—but would now serve as one of his pallbearers. We were trying to put together the pieces, repeating over and over what everyone said: “But he just wouldn’t leave his girls.” Then a small package arrived, which we opened—it was Cody’s new prescription for risperidone from Hines VA Hospital in Chicago.

Cody with his wife and daughters, Christmas 2020

I remembered seeing bottles of pills in the basement where Cody kept many of his things. We went down there and counted them. Seven pills left out of a bottle of fifteen risperidone, and the same for a bottle of aripiprazole, the generic form of Abilify. These were antipsychotics that Cody had been recently prescribed for a particularly serious bout of PTSD symptoms.

After looking these drugs up, and finding they both had black box warnings for suicidal ideation, as well as many other side effects, Cody’s family and friends soon came to the conclusion that these drugs had played a role in Cody’s death. A father whose own Navy son took his life expressed my feelings best after hearing my story:

Cody with his wife and daughters, Christmas 2020

“Cody got up every day for close to twenty years and handled his PTSD, then was on these drugs for about six weeks and was gone.”

Two days after the funeral, his wife and I went to a meeting with his therapist at the Hines VA Medical Center and the head of their suicide program. We thought they would want to hear what we thought about these drugs, that there would be some kind of investigation into Cody’s death. This was not the case. They did not respond to anything we said about the role of these drugs. They gave us brochures about grief counseling and told us that we just had to accept it.

I knew that I was unwilling to just accept this. My son was not suicidal before taking these drugs, and I wanted to do something about this issue, convinced that there must be other families who had lost veterans in the same way. I wrote letters to various legislators. I spent hours researching, trying to find at least newspaper accounts of suicides similar to Cody’s that might list the names of family members. I looked at statistics from the Veterans Administration. I read studies about these drugs. What I learned shocked me. Despite the tremendous number of post-9/11 veterans who resorted to suicide, there appeared to be little investigation into their deaths. Despite the widespread use of psychiatric drugs to treat veterans with PTSD by the VA, many of which have black box warnings for suicidal ideation, the VA does not appear to even keep a list of veterans who have taken their own lives after being prescribed these drugs by the VA. Why would anyone give drugs that may cause suicidal thinking to a population with such a high rate of suicide?

I knew at the beginning this would not be an easy fight. The use of these drugs by the VA is not a new issue, but I am a persistent person. Then, as I was feeling dejected about not being able to make a dent in this problem, close to three years after Cody’s death in 2021, a friend offered to hand-deliver a letter from me about Cody’s death to the head of the Veterans Administration. It would not really change anything but felt like a small step forward to me.

Below is the letter I wrote. I should have been more specific in asking for action by the Veterans Administration. I want the Office of the Inspector General to investigate the circumstances of Cody’s death, the quality of the treatment he received, and the role that antipsychotic drugs played in his suicide. More importantly, if the Veterans Administration is sincere in wanting to reduce veteran suicides, the first place to start is to collect information following these deaths to try to better understand the causes. Investigating Cody’s death is not enough—he was only one of tens of thousands we have lost. Real investigations of veteran suicides could point the way to effective treatment, not more drugs. You can’t fix a problem that you don’t understand.

Cody deserved better treatment when he showed up at the VA emergency room in a severe PTSD crisis, in a state of extreme anxiety and fear. I wish that somewhere in his medical records was a thorough evaluation of his mental state, as well as an “informed consent” document signed by him, testifying that the side effects of these drugs had been explained to him. Other families should not have to continue to experience the trauma of losing their beloved veterans the way thousands of us have. I remember well that very young man leaving for Iraq who told me about the contract he made with the federal government that he was honorably upholding. He was put in harm’s way by the decisions of the federal government and suffered for it for close to twenty years. When will the government uphold its end of the bargain by providing effective mental health care for veterans?

The following is the letter I sent to the head of the VA:

* * *

March 11, 2024

Dear Secretary McDonough:

Thank you for taking the time to read about the life and death of my son, Cody Camacho, who took his life on November 2, 2021 after close to 20 years of struggling with severe PTSD from his service in Operation Iraqi Freedom, 2003-2004. I last saw Cody in August 2021, and he was doing well, both physically and mentally. He then began experiencing severe PTSD symptoms which seemed worse than in the past.

He went to the Hines VA at least once a week during the last six weeks of his life, including one trip to the emergency room, and though he had resisted using these drugs in the past, agreed to be treated with two antipsychotics, first aripiprazole, commonly known as Abilify, and then, risperidone. Both of these drugs have black box warnings for suicidal ideation. They both have many well known side effects that seem like they would not be appropriate for those with PTSD, such as tardive dyskinesia, symptoms of which Cody described to me when I suggested taking his dogs for a walk when he felt anxious, saying he did not like to be in public because his arms and legs moved weird and he did not want people to think he was crazy. He said he felt the need to run at these times and could not stop. After being switched to risperidone, Cody took seven pills—we found the bottle after he died and counted them—and shortly after starting this new drug, he bought his children McDonald’s for dinner, called his wife at work, then took a gun and went to a hotel room.

The first thing all his many friends said after learning of Cody’s death was “He would never leave the kids.” It was my first thought. Cody was the devoted father of two young daughters, Desiree and Calina, and his life centered around them. He was someone who was very outgoing and loved people. He was someone people turned to when they were troubled, including many veterans he served with. He was vice commander of his American Legion chapter in Des Plaines at the time of his death, and was active in other community activities and his church. He was well known and well loved in his community, his funeral was huge and many contributed to this all day affair. He was just not suicidal before this time. His VA medical records also reflect this, that he was not considered at risk of suicide—his last appointment was about three days before he died. We firmly believe that the medication he was prescribed by the VA played a role in his death.

I went to Chicago to be with his wife immediately after his death, and the house was full of people for the whole week. I talked to many of his friends, people he was close to for 30 years, who reported his strange behavior right before he died. He told them he was marked, that someone was after him and was going to kill him. Cody had never acted like this before. His PTSD symptoms were primarily anxiety.

The morning after the funeral, his wife received a call from a VA neuropsychologist, who had been unable to reach Cody to set up an appointment. Unfortunately, he was already dead. Cody was driven to the Hines VA emergency room by another veteran on September 27 because of his extreme anxiety and strange behavior, where he was briefly seen and given Abilify, then sent home. Reading his medical records, I learned that during the time between his emergency room visit and his death, Cody visited the VA numerous times, for appointments with his regular counselor or with the psychiatrist prescribing these drugs. I did not see any real evaluation of what was happening to him, or any treatment plan. In fact, throughout his medical records I did not notice any specific treatment plan for PTSD, although he did attend some group events on PTSD management. Notes from his office visits mainly consisted of discussing family issues. There was little talk of Iraq or the source of his PTSD at all. Cody was so scared during this time, he sought help. Over and over. He wanted to get better.

Cody joined the Army on his 18th birthday in 2000, and was deployed to Iraq with the initial invasion. He was in the signal corps and provided communications support at the Abu Ghraib prison for most of his deployment. He turned 21 at the Abu Ghraib prison. After returning from Iraq, Cody began having frequent and severe panic attacks and constant anxiety, he had difficulty in crowds and finding employment. He then went back to the Army, and had various assignments in the reserves in human resources, serving as the administrator for reserve units. He served in total about 17 years, attaining the rank of sergeant with many awards and commendations. He served honorably. He spent most of his adult life struggling with PTSD. He deserved better treatment, actual treatment, not drugs that many, including mental health professionals, think questionable in the treatment of PTSD.

Most troubling to me is the lack of information I have been able to find on cases where veterans were prescribed these drugs and then committed suicide. I am not a medical professional, but I am a professional, a retired college professor. I am a researcher. These drugs, with known side effects, continue to be used “off label”, and there does not seem to be any body of research concerning how many veterans take their lives while on medication prescribed by the VA. No one investigated Cody’s death. He did not even have an autopsy. I often wonder, had we not told them Cody was dead, whether the VA would even know.

Sincerely,

Jeri L. Reed